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15 Cards in this Set
- Front
- Back
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Classifications of cardiac disease
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on page 346
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class 1 and 2
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usually have normal pregnancy with few if any problems
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class 3 and 4
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are at much greater risk for cardiac decompensation and other complications
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effect of pregnancy on CV system
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progressive increase in Cardiac output
increasing blood volume until 32nd week, then constant increased O2 consumption increased fluid retention decreased vascular retention and bp |
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difficulties in diagnosing cv problems during pregnancy
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murmurs common
false impression of cardiac enlargement progesterone causes accentuating breathing effort |
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cardiac disease and pregnancy decision
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must understand risks
desire to continue with unplanned pregnancy is termination acceptable? |
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greatest threat during pregnancy with heart disease
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congenital heart failure
increase blood volume-->cardiac decompensation-->decreased placental perfusion--->high risk prematurity and IUGR |
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medical management of pregnancy and heart disease
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preconception counseling about consequences of preg.
diuretics digoxin anti-dysrythmics anticoagulants antibiotics O2 evaluate fetal status |
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Nursing interventions of pregnancy and heart disease
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monitor cardiac status
stress continuing with all appt.: q2 weeks 1st half, q1 week 2nd half assess: vs, ekg, activity tolerance, FHR |
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FHR
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Fetal Heart Monitor
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KNOW
assess for and teach client signs/symptoms of decompensation |
Frequent, persistent cough with or without hemoptysis
increasing fatigue/difficulty breathing with her usual activities progresive dyspnea orthopnea, feeling of smothering progressive adema (esp face) palpitations: irregular, weak, rapid, pulse crackles at base of lungs RR>25 cyanosis of lips and nail beds |
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hemoptysis
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coughing up blood
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Prevention of decomposition
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promote adequate nutrition, rest, and protect from infection
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Labor and delivery prep for cardiac disorders
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vag delivery preferred
sidelying or upright O2 mask continual maternal and fetal monitoring avoid beta-adrenergics-assoc. with myocardial ischemia penicillin prophylaxis |
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Postpartum care of cardiac disorders
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monitor closely
at risk for decompensation for up to one week esp first 48hrs |
